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									                                              Dental Implants Policy Statement

                                     NHS Swindon is the brand name for the organisation
                                       legally known as Swindon Primary Care Trust

Note: This document is electronically controlled. The master copy is maintained by the Clinical
        Governance Department. If this document is printed it becomes uncontrolled.

  Dental Implants Policy Statement        Commissioning (PS39)   Issue 2   Approved 08/10/2009   Expiry 07/10/2011   Page 1 of 3
                                   Dental Implants Policy Statement

   Date of Issue:                  April 2008
   Reviewed:                       July 2009
   Review Date:                    July 2011

   Swindon PCT will commission dental implants as a RESTRICTED
   PRIORITY for edentulous or partially dentate patients under the
   following circumstances only:

          where there is a clinical need AND
          where all other alternative treatments are either not
           appropriate, or have been tried and have not been successful,
           such that dental implants are recommended by a consultant in
           restorative dentistry because oral function cannot be achieved in
           any other way.

   Dental implants will be commissioned only for people who require
   reconstructive treatment as a result of

         1. head and neck cancer, or other extensive loss of oral and facial
            tissues which has resulted in permanent loss of oral function;
         2. rare genetic conditions, eg, severe hypodontia, clift lip/palate such
            that the patient cannot achieve oral function;
         3. multiple traumatic tooth loss which has resulted in permanent loss
            of oral function.

   In all instances prior to the provision of dental implants, the consultant in
   restorative dentistry should:

          be satisfied that the patient is able to cope with the necessary
           aftercare of dental implants
          take account of the patient’s prognosis
          delay treatment in young individuals until growth is complete

Dental Implants Policy Statement     Commissioning (PS39)   Issue 2   Approved 08/10/2009   Expiry 07/10/2011   Page 2 of 3
   As advised by the Faculty of Dental Surgeons, dental implants are
   contraindicated in people who smoke tobacco as this compromises
   treatment success; the referring clinician must be satisfied that this
   criterion is met prior to surgery being agreed. Dental implants may also
   be contraindicated in people who

              have severe psychoses/neuroses
              immunodeficiency
              bleeding disorders
              drug/substance misuse (including alcohol)
              bone disorders (excluding osteoporosis)
              are at high risk of developing infective endocarditis
              have poor oral hygiene and untreated peridontal disease

   Under the terms of this Restricted Policy, all referrals for dental
   implant surgery for patients who meet the criteria described above
   must receive prior approval from the Swindon PCT Clinical
   Priorities Committee. Applications should provide information in
   relation to the stated eligibility criteria, including smoking status.

   Swindon PCT will NOT NORMALLY FUND dental implants for cosmetic
   purposes. Exceptionally, individual applications for cosmetic dental
   implants will be considered by the Clinical Priorities Committee.

   In all cases it should be noted that, following successful application for
   dental implant(s), the cost of maintenance and any future replacement
   will require a new application for approval.

   Where dental implant surgery is agreed, restorative dental treatment will
   be commissioned from a specialist tertiary centre.

   Jenny Harries
   Director of Public Health                                                              August 2009
   Agreed at Clinical Advisory Forum: 21 September 2007
   Agreed at PEC: 8 November 2007
   Reviewed by John Haines, PCT Dental advisor, July 2009
   Agreed at PEC 8 October 2009

Dental Implants Policy Statement   Commissioning (PS39)   Issue 2   Approved 08/10/2009       Expiry 07/10/2011   Page 3 of 3

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